| NPI | 1790154094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health (Licence: SD LPCMH2285) | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2015-09-28 |